Getty/Zdorovoe Otechestvo/e2w

Vladimir Putin 's hands are looking pretty rough these days ... prompting people to speculate about his health -- again!

The Russian strongman showed off his mitts for the cameras while recently meeting with 22-year-old health expert Yekaterina Leshchinskaya to chat about potentially banning e-cigarettes from being sold inside the former Soviet Union.

Check out the video ... as Leshchinskaya talks directly to Vlad in front of spectators, Putin clenches his fists with puffy fingers and worm-like veins under his wrinkly skin.

After her speech, Leshchinskaya shakes one of Vlad's hands without even flinching. Play video content

Back in August, rumors spread like wildfire that Vlad's health was declining after a video surfaced of him standing with Pre

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